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Westfield Fashion Square // Unit 18 14006 Riverside Drive // Sherman Oaks, CA 91423
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Sayana Medical & Wellness Center
Functional Medicine – Sherman Oaks, California
Sherman Oaks, CA
1-818-331-4386
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Home
About
About
What’s Functional Medicine
Team
Services
Get Directions
Services
Reboot & Rebalance Program
Clarity Program
Medical Visits
Hair Restoration Program
IV Vitamins and Injections
Skin Rejuvenation
Acupuncture & FSM
Special Functional Testing
Resources
Free Hormone Makeover Blueprint
Free Weight Loss Guide
Free Gut & Hormones Quiz
Free Weight Loss Quiz
Store
Hormone Balance
Immune Health
Blood Sugar & Weight Management
Energy & Stress Management
Hair, Skin & Nails
Neurological Health
General Wellness
Cardiovascular Health
Detox
Gut Health & Elimination
Mood & Sleep Support
ON SALE
WHAT’S NEW
Contact
Work with Us
Home
About
About
What’s Functional Medicine
Team
Services
Get Directions
Services
Reboot & Rebalance Program
Clarity Program
Medical Visits
Hair Restoration Program
IV Vitamins and Injections
Skin Rejuvenation
Acupuncture & FSM
Special Functional Testing
Resources
Free Hormone Makeover Blueprint
Free Weight Loss Guide
Free Gut & Hormones Quiz
Free Weight Loss Quiz
Store
Hormone Balance
Immune Health
Blood Sugar & Weight Management
Energy & Stress Management
Hair, Skin & Nails
Neurological Health
General Wellness
Cardiovascular Health
Detox
Gut Health & Elimination
Mood & Sleep Support
ON SALE
WHAT’S NEW
Contact
Work with Us
Note: Your Results will be displayed after Submission.
The Patient Health Questionnaire (PHQ-9)
Name
*
First
Last
Email
*
Date of Visit
*
MM slash DD slash YYYY
Phone
*
The Patient Health Questionnaire (PHQ-9)
Over the last 2 weeks, how often have you been bothered by the following problems?
Little interest or pleasure in doing things
*
Not at all
Several Days
Half the Days
Nearly Every Day
Feeling down, depressed or hopeless
*
Not at all
Several Days
Half the Days
Nearly Every Day
Trouble falling asleep, staying asleep, or sleeping too much
*
Not at all
Several Days
Half the Days
Nearly Every Day
Feeling tired or having little energy
*
Not at all
Several Days
Half the Days
Nearly Every Day
Poor appetite or overeating
*
Not at all
Several Days
Half the Days
Nearly Every Day
Feeling bad about yourself - or that you're a failure or have let yourself or your family down
*
Not at all
Several Days
Half the Days
Nearly Every Day
Trouble concentrating on things, such as reading the newspaper or watching television
*
Not at all
Several Days
Half the Days
Nearly Every Day
Moving or speaking so slowly that other people could have noticed. Or, the opposite - being so fidgety or restless that you have been moving around a lot more than usual
*
Not at all
Several Days
Half the Days
Nearly Every Day
Moving or speaking so slowly that other people could have noticed. Or, the opposite - being so fidgety or restless that you have been moving around a lot more than usual
*
Not at all
Several Days
Half the Days
Nearly Every Day
Thoughts that you would be better off dead or of hurting yourself in some way
*
Not at all
Several Days
Half the Days
Nearly Every Day
If you checked off any problems, how difficult have those problems made it for you to Do your work, take care of things at home, or get along with other people?
*
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
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